Individual
KATHLEEN JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 ALDRICH ST, HUNTINGTON STATION, NY 11746-2632
(631) 223-3637
Mailing address
11 ALDRICH ST, HUNTINGTON STATION, NY 11746-2632
(631) 223-3637
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402276-1
NY
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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